Provider Demographics
NPI:1528076460
Name:MARCHESE, WILLIAM A (DDS MS)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:A
Last Name:MARCHESE
Suffix:
Gender:M
Credentials:DDS MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:327 N WASHINGTON AVE
Mailing Address - Street 2:STE 609
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18503-1539
Mailing Address - Country:US
Mailing Address - Phone:570-961-6030
Mailing Address - Fax:
Practice Address - Street 1:327 N WASHINGTON AVE
Practice Address - Street 2:SUITE 609
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18503-1549
Practice Address - Country:US
Practice Address - Phone:570-961-6030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS21027L1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics